Individual provider Active NPI

David Witman, PT

  • Physical Therapist
  • Oakwood, GA
National Provider Identifier
1447343165
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
006662 Issued in GA
Practice address
4220 Mundy Mill PL
Suite 2B
Oakwood, GA 30566-2573
Phone
(678) 450-9933
Fax
(678) 450-9966
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 006662 GA Primary

Addresses

Primary practice location

4220 Mundy Mill PL
Suite 2B
Oakwood, GA 30566-2573

Mailing address

2400 Wisteria Dr
Suite a
Snellville, GA 30078-2689
Phone (770) 982-0102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130508000609 GA Practitioner - Physical Therapist in Private Practice 7113164286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4220 Mundy Mill PL
Suite 2B
Oakwood, GA 30566-2573
Phone (678) 450-9933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006662GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Rehabilitation and Performance Center CurrentSince Jun 16, 2003 Accepting new patients
Atlanta Rehabilitation and Performance Center CurrentSince Jun 16, 2003 Accepting new patients

Locations

2800 Buford Dr
Ste 315
Buford, GA 30519
Phone (678) 450-9933

575 Professional Dr
Ste 370
Lawrenceville, GA 30046
Phone (678) 205-5420

4220 Mundy Mill Pl
Ste 2B
Oakwood, GA 30566
Phone (678) 450-9933

2400 Wisteria Dr
Ste A
Snellville, GA 30078
Phone (770) 982-0102

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1447343165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 WISTERIA DR",
            "address_2": "SUITE A",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782689",
            "telephone_number": "770-982-0102",
            "fax_number": "770-982-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 MUNDY MILL PL",
            "address_2": "SUITE 2B",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305662573",
            "telephone_number": "678-450-9933",
            "fax_number": "678-450-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITMAN",
        "first_name": "DAVID",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "006662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakwood, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.